Characteristics and Needs of Long-Stay Forensic Psychiatric Inpatients: A Rapid Review of the Literature

ABSTRACT

This rapid review summarizes currently available information on the definition, prevalence, characteristics, and needs of long-stay patients within forensic psychiatric settings. Sixty nine documents from 14 countries were identified. Reports on what constitutes “long-stay” and on the characteristics of long-stay patients were inconsistent. Factors most frequently associated with longer stay were seriousness of index offence, history of psychiatric treatment, cognitive deficit, severity of illness, diagnosis of schizophrenia or psychotic disorder, history of violence, and history of substance misuse. Although some countries are developing specific long-stay services, there is presently no consensus on what might constitute “best practice” in such settings.

KEYWORDS:

• Forensic psychiatry
• length of stay
• long-stay patients
• mentally disordered offenders
• patients' needs

Funding

This study was partly funded by the National Institute for Health Research, Health Services and Delivery Research Programme (Portfolio 129376); reference HS&DR 11/1024/06. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HS&DR Programme, NIHR, NHS, or Department of Health. The sponsor was Nottinghamshire Healthcare NHS Foundation Trust.

Notes

¹ The term “mentally disordered offender” is used here to describe a person who has a disability or disorder of the mind and has committed or is suspected of committing a criminal offence. It differs from the “MDO” population in California which is based on the legal commitment and is used to describe a specific class of prisoners who have their own set of California parole laws.

² This system was introduced into Dutch penal law in 1928 and allows those with reduced criminal responsibility to be detained and treated in forensic-psychiatric hospitals rather than in prison. TBS can be loosely translated as ‘at the disposal of the government’. The TBS system provides a separate long-stay stream to which patients with treatment duration of over 6 years can be admitted.